Association between socioeconomic status and prevalence of non-communicable diseases risk factors and comorbidities in Bangladesh: Findings from a nationwide cross-sectional survey

Tuhin Biswas, Nick Townsend, Md Saimul Islam, Md Rajibul Islam, Rajat Das Gupta, Sumon Kumar Das, Abdullah Al Mamun

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Abstract

Objectives This study aimed to examine the prevalence and distribution in the comorbidity of non-communicable diseases (NCDs) among the adult population in Bangladesh by measures of socioeconomic status (SES). Design This was a cross-sectional study. Setting This study used Bangladesh Demographic and Health Survey 2011 data. Participants Total 8763 individuals aged ≥35 years were included. Primary and secondary outcome measures The primary outcome measures were diabetes mellitus (DM), hypertension (HTN) and overweight/obesity. The study further assesses factors (in particular SES) associated with these comorbidities (DM, HTN and overweight/obesity). Results Of 8763 adults, 12% had DM, 27% HTN and 22% were overweight/obese (body mass index ≥23 kg/m2). Just over 1% of the sample had all three conditions, 3% had both DM and HTN, 3% DM and overweight/obesity and 7% HTN and overweight/obesity. DM, HTN and overweight/obesity were more prevalent those who had higher education, were non-manual workers, were in the richer to richest SES and lived in urban settings. Individuals in higher SES groups were also more likely to suffer from comorbidities. In the multivariable analysis, it was found that individual belonging to the richest wealth quintile had the highest odds of having HTN (adjusted OR (AOR) 1.49, 95% CI 1.29 to 1.72), DM (AOR 1.63, 95% CI 1.25 to 2.14) and overweight/obesity (AOR 4.3, 95% CI 3.32 to 5.57). Conclusions In contrast to more affluent countries, individuals with NCDs risk factors and comorbidities are more common in higher SES individuals. Public health approaches must consider this social patterning in tackling NCDs in the country.

Original languageEnglish
Article numbere025538
JournalBMJ Open
Volume9
Issue number3
Early online date13 Mar 2019
DOIs
Publication statusPublished - 13 Mar 2019

Funding

5Departmnet of Statistics, University of Rajshahi, Rajshahi, Bangladesh 6Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand 7Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh 8Centre for Science of Implementation and Scale-Up , BRAC James P Grant School of Public Health, BRAC university, Dhaka, Bangladesh Acknowledgements The authors thank MEASURE DHS for permission to use data from the 2011 Bangladesh DHS. The authors are also grateful to Mehedi Hasan, University of Queensland, Australia. Review Board, Maryland, USA and National Research Ethics Committee of Bangladesh Medical Research Council (BMRC), Dhaka, Bangladesh. Informed verbal consent was obtained from all survey participants.

Keywords

  • Bangladesh
  • diabetes
  • hypertension
  • non-communicable disease
  • overweight
  • socioeconomic status

ASJC Scopus subject areas

  • General Medicine

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